!! Chapter 35 Comfort and Pain Management Flashcards
What are the 3 categories of pain?
- Duration
- localization/location
- etiology
What are the 5 sources of pain?
- nociceptive
- cutaneous
- somatic
- visceral (splanchnic pain)
- neuropathic
What is pain where there is actual or threatened damage to peripheral tissues and is representative of the normal pain process?
Nociceptive
What is pain where it involves the cutaneous layer, superficial skin, and subcutaneous tissue?
Cutaneous
What is deep tissue pain and where does it originate?
Somatic
-originates in ligaments, blood vessels, nerves, tendons, or bones
What is pain that originates in body organs such as the thorax, cranium, and abdomen?
Visceral (splanchnic pain)
What is pain from a lesion or disease of the CNS or PNS?
Neuropathic
A patient who has bone cancer is most likely experiencing which of the following types of pain?
Somatic
What are the 3 origins of pain?
- Physical (cause of pain can be identified)
- Psychogenic (cause of pain cannot be identified)
- Referred (pain is perceived in an area distant from its point of origin)
What are the 4 parts to the pain process?
- Transduction
- Transmission
- Perception of pain
- Modulation
What stage of the pain process involves the activation of pain receptors, that involves conversion of painful stimuli into electrical impulses that travel from the periphery to the spinal cord at the dorsal horn.
Transduction
What stage of the pain process involves the conduction along pathways (A-delta and C-delta fibers). Pain sensations from the site of an injury or inflammation are conducted along pathways to the spinal cord and then on to higher centers.
Transmission
What stage of the pain process is when you are aware of the characteristics of pain?
Perception
What stage of the pain process involves the inhibition or modification of pain?
Modulation
What are receptors that recognize pain and send the signals to CNS?
Nociceptors (pain receptors)
What is a powerful vasodilator that increases capillary permeability and constricts smooth muscle. Also gets more blood flow to the area.
Bradykinin
What is an important hormone-like substance that sends additional pain stimuli to the CNS?
Prostaglandins
What sensitizes receptors on nerves to feel pain and also increases the rate of firing of nerves?
Substance P
What stimulates smooth muscle and inhibits gastric secretion and produces vasoconstrictions.
Serotonin
What are 4 types of nociceptors?
- Bradykinin
- Substance P
- Serotonin
- Prostaglandins
What is the gate control theory of pain?
Describes the transmission of painful stimuli and recognizes a relationship between pain and the projection of pain information to the brain (emotions).
What nerve fibers conduct excitatory pain stimuli toward the brain, exaggerating the effect of the arriving impulses through a positive feedback mechanism.
Small (C-delta fibers)
What nerve fibers appear to inhibit the transmission of pain impulses from the spinal cord to the brain through a negative feedback system.
Large (A-delta fibers)
The Gating mechanism:
- determines the impulses that reach the brain.
- Ex: If you can rub the injury site then you will stimulate the large nerve fibers and decrease the level of pain experienced by the person.
What nerve fibers convey diffuse, longer-lasting pain that is triggered by chemical stimuli or persistent mechanical or thermal stimuli?
Small (C-delta fibers)
What nerve fibers transmit acute, well-localized pain that is typically elicited by mechanical or thermal stimuli?
Large (A-delta fibers)